HIV Risk

[jennys]

Hi, I did a rather stupid thing and had unprotected sex with a friend, he did ejaculate inside of me.  He has not gotten tested for HIV in about a year and a half and has 2-3 (I don't know for sure) female sexual partners.  He is not a known drug user and has never had sex with a male (to the best of my knowledge).  I asked him to get tested and he said he would eventually but it wasn't on his priority list and that I had nothing to worry about.  What are my chances of contracting HIV and what is the soonest point that I could test where I would feel comfortable that the results were accurate?  

On another note, I was on birth control but stopped several months ago because of lack of insurance.  I still have a pack of mononessa left, do you know if I can use that as kind of a morning after pill?  

Thanks

[H. Hunter Handsfield, M.D.]

In most populations in the U.S. the likelihood that someone like your friend has HIV is extremely low.  I wouldn't lose sleep over it.  But if you want to be tested to be sure, wait 4 weeks.  (Official recommendation is still 3 months, but with the modern HIV tests 4 weeks almost always is enough time for the result to turn positive.)

I don't know that particular pill and I'm not a gynecologist; I can't say whether it would be effective as emergency contraception or what dose to use.  Sorry!

Good luck--  HHH, MD

[tfe]

Hi there,

I hope I can perhaps give you a few pointers to help while you're waiting for an official response from the doctor.

Regardless of anything the person with whom you had intercourse told you, there is no way without knowing the HIV-status of the guy to determine if he has it or not (this includes 'symptoms', etc).

In fact, Dr. Handsfield has posted some articles on this site about the risk of a single unprotected exposure. If you visit http://www.medhelp.org/forums/STD/messages/512.html, you will see that he states "On average, it is believed the chance of HIV transmission during a single episode of unprotected vaginal sex is around one in 1000. But it varies widely depending on sex (more efficient male to female), circumcisison (higher risk for uncircumcised men), stage of HIV infection, presence of other STDs, and other factors." Hopefully that makes you feel a bit better about the risk.

Also, if you visit http://www.medhelp.org/forums/STD/messages/708.html, you will learn that the time to positive HIV test is "sometimes positive as soon as 10 days, usually positive by 3 weeks, and virtually always positive by 6 weeks, despite official advice that it is best to wait 3 months to be sure. If your HIV test is negative 6 weeks after exposure (and especially after 12 weeks), you don't have HIV, period."

As for your last question, I'll let the doctor answer that, but to the best of my knowledge, PEP (Post-Exposure Prophylaxis) are the only "morning after pills" (actually, within 72 hours; the sooner the better)  that would reduce your chances if you had a significant exposure (which, medically, I don't believe a single episode of unprotected vaginal sex with a male of unknown serostatus qualifies for - but again, I'm not a Doctor).

In any event, it seems like you have everything going in your favor. It'd be wise to test at the end of the window period and suggest that the person with whom you slept does the same.

Again, I'm not a Doctor or medical professional, but I hope my comment can put you at ease until Dr. Handsfield has a moment to reply to your message.

Take care!

- F.

[monkeyflower]

You can use larger doses of some birth control pills as emergency contraception, but I'm not sure which ones (or if that matters) and how much. Before you do anything, I'd call your doctor or the pharmacist and ask if that's appropriate for you. However, you'd probably be far better off asking for a prescription for Plan B, usually known as the morning after pill. It's less likely to cause the unpleasant side effects (nausea, etc.) of larger doses of regular birth control, and it's more effective. You have up to five days after unprotected sex to take it, but the sooner you take it, the more effective it will be. I think it costs around $25 US; if money's an issue, go to Planned Parenthood. It really sucks that it's still not available OTC...

[jennys]

Thanks guys.  I called Planned Parenthood and they were not helpful at all, I think I may have just gotten a girl who was having a bad day.  I asked about my birth control pills and her response was "I have no idea."  I called my dr but she will just tell me to come in for an appt. and I can't really afford to do that.  Why do I get myself into these situations, it's my own fault?!!

[tfe]

Don't beat yourself up over it -- it happens to the best of us.

The odds are astronomically in your favor that whatever happened between you and that guy won't have a drastic long term irrepairable effect on you... Just remember what you're going through now next time you're in that position.

Take care!

- F.

[Christie2004]

If you called PP and asked if you could use your own pills as a make-do type of morning after pill to prevent pregnancy, no doubt she couldn't have advised you on it.

Look at it this way:  Which would be cheaper, an unplanned pregnancy from someone you don't love, or a visit to PP (which, by the way, is not expensive at all)?

For Gods sake, bite the bullet, call PP or your own GYN, tell them you need emergency contraception, and get it.  You must take it within 72 hours.  

I looked it up online, and the hormones in Mononessa are NOT used for EC.  Go to

http://ec.princeton.edu/

and read up on what to do if you don't intend to become pregnant by this jerk who won't even get an HIV test.

[H. Hunter Handsfield, M.D.]

I'm a little surprised the Planned Parenthood provider blew you off; they should know, or at least be forthcoming in telling you where to call.

A general point, however:  Your local pharmacist is a great resource for questions of that sort.  And depending on the state you live in, you might be able to get reliable emergency contraception directly from the pharmacy, with a prescription by a doctor.

HHH, MD